Painful Procedures in the Emergency Department

Many children experience significant levels of pain while they are in the Emergency Department (ED). One of the most common causes of pain for children in the ED is needles for blood draws or IV starts. There is some evidence that parent-directed coping techniques (such as deep breathing and distraction) can be used effectively to reduce the pain that children experience when they undergo medical procedures in the ED.

The main purpose of this study is to see if the pain and anxiety that children experience when they have needles can be reduced by watching an instructional video designed to educate parents and children about what is going to happen, to teach coping skills that can be used before and during the procedure, and to provide entertaining video distraction during the procedure. It is hoped that this study will lead to the development of protocols and equipment that can be used to reduce the burden of pain experienced by children attending Emergency Departments across Canada.

The study will also evaluate pain coping among children in an ED setting and to see if pain coping strategies between children in two cultures (Canada and Iceland) differ. Culture has been considered an important factor influencing pain and pain coping. There is some evidence that children’s use of coping strategies can affect their pain experience. Information about the cultural aspects of pain and pain coping are needed, enabling health care providers to better care for children of different ethnicities.

This study is under the direction of Dr. Patrick McGrath, Professor of Psychology, Pediatrics and Psychiatry at Dalhousie University and a Psychologist at the IWK in Halifax, NS.

Children between the ages of 6 and 12 years of age who are in the ED requiring needles for blood collection or IV starts are being invited to take part in this research study. The study will take place in the procedure areas of the Emergency Department at the IWK Health Centre. Approximately 168 families will be involved in this study. In order for this study to show that distraction techniques and coping strategies for parents and children reduce pain and anxiety, it is important that we compare these techniques to the strategies that are usually given in the ED. Therefore, after this form is signed, it will be decided by chance (like “flipping a coin”) which families will be treated with the distraction techniques and which will receive the usual care in the ED. That means that 50% of the families will receive intervention and 50% will receive the standard medical care.

The Team: